Wow, 2011. One year from now, it will be 2012, and I will be entering my final clinical placements. This has simultaneously been the longest and shortest 4 years of my life - mostly in that I haven't spent 4 years doing the same thing before.

I started my L&D rotation a few days ago. Okay, okay - despite how much I thought I would detest the idea of being an L&D nurse, I can see how it might grow on me... :)

We are placed at an inner-city hospital with a really nice new wing created specifically for maternity. It has assessment & induction, antepartum, L&D, postpartum, NICU, and obs surgery all in the same wing. I was surprised and pleased to see the focus on family-centered care. Most of the babies barely leave their moms, except for assessments and initial baths.

Being inner-city, the patient population reflects everything from wealthy, prepared, crunchy granola moms who have read every book on gestation published since 1980, all the way to homeless women with no prenatal care and whose babies are detoxing from street drugs. There are recent immigrants and teenagers and the physically and mentally ill. There are high-risk moms flown in from northern Canada. It is a MUCH more dynamic cross section of life than I expected - really.

On Wednesday, we attended Ye Olde Orientation at my school. It's the same stuff we've heard before. WHMIS videos and fire safety videos, per Alberta Health Services protocol. I then met up with my clinical group and instructor. She has been an L&D nurse for 10+ years (and is still!), which is super exciting, because my last 2 instructors haven't been at the bedside in 20 years.

We had our orientation onto the unit. We are starting on Postpartum. My orientating nurse was great! She was a younger RN and it was nice to be with someone who wasn't quite so practiced at it. Sometimes it is hard to pick up on techniques used by really experienced nurses. She was fun and really wanted to teach me, and with me being the sponge that I am, it was a very productive day.

There was a lot more teaching to be done than I ever expected. Some of the moms would ask question after question, especially just after the pediatricians rounded on them, so we could interpret med speak. Lots of questions about breastfeeding. LOTS of questions about breastfeeding. I have a lot of studying to do to, so I can answer all these questions with any degree of competency :)

We saw a mom who was afraid to supplement her 2 day old 37 weeker because she really wanted to breastfeed her, but her milk wasn't really coming in yet. However little babe was losing weight and was getting more lethargic, and sucking less. I saw my RN smoothly convince this nervous mom that she could supplement the baby without worrying about nipple confusion with just one resourceful remedy - the nurse cut the needle off a butterfly infusion set, leaving just the tubing, and used a 3 mL syringe to draw up some formula, and then she attached the tubing. Mom got baby on the breast and the nurse squeaked the tiny tubing into the corner of baby's mouth. She was then able to supplement the baby while the mom nursed. Baby got 10 mLs+ of formula and sucked with gusto once she realized she was getting the goods. Win-win-win - it was GENIUS. I am still telling everyone about it! I was so impressed! Even better, we taught dad to use the syringe at the next feeding. He really wanted to help and he did great. We worked ourselves out of a job in that room :)

Another mom got really sick. Failed vacuum, baby delivered with forceps, 3rd degree tearing and episiotomy. She spiked a 40° fever and raging infection and was put into an ice bath to bring down her temp (I didn't see any of this, but I heard about it in report). When we rounded on her, she was so, so, so tired and very apathetic about baby. Can't say I blame her. Her peri area looked really angry and the only thing she ever rang for was more ice packs.

Third mom was absent for most of my shift because she was up in the NICU with babies A and B.

We also toured the nursery area and I got to play with my very first baby, the tiny little girl who required supplementation. I listened to her heartbeat. I don't even know how you are supposed to count it....shiza.

Seriously, wrapping babies into a tiny parcel is harder than it looks. They stick their hands and feet all over the place. You swaddle one side and the other side escapes! I hope I get the hang of it, LOL :)

Lots of studying tonight, lecture tomorrow, and back on the unit with my own assignment on Tuesday!